Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable.
Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke.
Methods: The study subjects included 30 patients with stroke, who were divided into aquatic (n1= 15) and ground (n2=15) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg.
Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different.
Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

Abstract
Introduction
Methods
    Subjects
    Instruments
    Procedures
    Statistical Analyses
Results
Discussion
Conclusion
References

• Hyun-chul Hwang(Dept. of Physical Therapy, Daegu University)
• So-hee Kim(Dept. of Physical Therapy, Daegu University) Corresponding author
• Tae-ho Kim(Dept. of Physical Therapy, Daegu University)